Multi-dose packaging medication administration system

ABSTRACT

A medication administration and verification system includes scanning a code for a cavity of a multi-dose package to identify at least one previously prescribed medication determined at a time of packaging the at least one previously prescribed medication in the cavity. A list is received in response to the electronically encoded package identifier for at least one currently prescribed medication. At least one visual indicator is displayed respectively corresponding to the at least one currently prescribed medication for the patient for administration during the medication administration event, and a presence or exclusion of each of the currently prescribed medication in the cavity is automatically confirmed for the presence or the exclusion of in the cavity.

CROSS REFERENCE TO RELATED APPLICATION(S)

The present application is a continuation of U.S. patent applicationSer. No. 16/702,951, titled “Multi-Dose Packaging MedicationAdministration System,” filed Dec. 4, 2019, which claims priority toU.S. Patent Application No. 62/776,623, titled “Multi-Dose PackagingMedication Administration System,” filed Dec. 7, 2018, both of which arehereby incorporated by reference in their entireties.

TECHNICAL FIELD

The present disclosure generally relates to medication administration,and more particularly relates to systems and methods for verification ofcurrently prescribed medications.

BACKGROUND

Safety and time-efficiency are important factors in the administrationof medications, particularly in institutional settings such as assistedliving facilities, long-term care facilities, rehabilitation facilities,correctional facilities, hospitals, and others. Residents or patientsmay take medications multiple times a day, each time they are takingmeds they may be taking multiple prescriptions. Caregivers (sometimescalled “medication aide aides”) may use a med cart stocked with theprescriptions for a group of patients, organized by patient, for aparticular administration time (e.g., morning, afternoon, evening,bedtime, breakfast, lunch, dinner, etc.). For safety, caregivers areexpected to verify the patient and each medication delivered andadministered against a manifest that accurately represents the patient'scurrent medication regimen. For time-efficiency, there is a need tostreamline this process, while making it as simple and easy-to-followfor the caregiver as possible.

Electronic medication administration records (eMAR) are softwareapplications used by caregivers to manage and track medicationadministration during med passes. eMAR has replaced conventional paperlogs or manifests in many facilities, enabling caregivers to more easilymanage the verification and logging steps of medication administrationthrough a computer, tablet, smartphone, or other electronic interface.eMAR systems may include patient and prescription databases and/or mayinterface with electronic health record (EHR) systems and other facilitymanagement, business, and information systems. eMAR systems may allowmedication administration data to be stored, audited, and used tosupport compliance, billing, and other business and administrativefunctions for the facility.

Medications are sometimes packaged in multi-dose packages. This maypresent challenges when there are changes in therapies that may bemissed by the medication aide. In the event a medication packaged inmulti-dose has been discontinued, the medication needs to be identifiedand removed at or prior to the point of administration.

Efficiency, simplicity, and ease-of-use in medication administration andverification may also increase the likelihood of adopting similar safetypractices by consumers and in-home caregivers.

SUMMARY

The present disclosure describes, among other things, various aspectsfor reducing medication administration duration and errors. In general,one innovative aspect of the subject matter described in this disclosuremay be embodied in a computer-implemented method, comprising: scanning,by a computing device, a code for a cavity of a multi-dose package, thecode corresponding to an electronically encoded package identifierconfigured to identify at least one previously prescribed medication fora patient for administration during a medication administration event,and the cavity including at least one previously prescribed medicationas determined at a time of packaging; receiving, by the computingdevice, a list in response to the electronically encoded packageidentifier for at least one currently prescribed medication for thepatient for administration during the medication administration event;displaying, by the computing device, at least one visual indicatorrespectively corresponding to the at least one currently prescribedmedication for the patient for administration during the medicationadministration event; automatically confirming, by the computing device,a presence or an exclusion of at least one currently prescribedmedication in the cavity; and respectively indicating, by the computingdevice, at least one visual indicator in response to the confirming thepresence or the exclusion of each of the at least one currentlyprescribed medication in the cavity.

Implementations may include one or more of the following features. Acomputer-implemented method where indicating each of the at least onevisual indicator in response to the confirming of the exclusion of atleast one currently prescribed medication in the cavity, furthercomprises differently indicating as a recently prescribed medication notpreviously available for packaging in the cavity for each of the atleast one visual indicator in response to the exclusion in the cavity ofthe at least one of the currently prescribed medication. Also, themethod further comprises differently indicating as a medication excludedfrom packaging in the cavity for each of the at least one visualindicator corresponding to at least one of the currently prescribedmedication in response to the confirming the exclusion of the at leastone currently prescribed medication in the cavity.

Yet, the method further comprises automatically confirming, by thecomputing device, the presence of the at least one previously prescribedmedication in the cavity that is discontinued in the list of the atleast one currently prescribed medication; and differently indicating asa medication discontinued as being prescribed for each of the at leastone visual indicator respectively corresponding to the at least onepreviously prescribed medication in the cavity that is discontinued fromthe list of the at least one currently prescribed medication to not befor administration during the medication administration event.

Further, the method further comprises identifying the at least onepreviously prescribed medication in the cavity that is discontinued fromthe list of the at least one currently prescribed medication usingrespective images of the at least one previously prescribed medicationfor the patient in the multi-dose package; and receiving, by thecomputing device, a confirmation that the at least one previouslyprescribed medication in the cavity that is discontinued from the listof the at least one currently prescribed medication was identified tonot be for administration during the medication administration event.

Also, the receiving a list in response to the electronically encodedpackage identifier, further comprises: accessing prescription datadesignated by the electronically encoded package identifier to obtainthe list for the at least one currently prescribed medication for thepatient for administration during the medication administration event.Further, the method comprises filling the cavity of the multi-dosepackage with the at least one previously prescribed medication; andprinting the code on the cavity to identify the at least one previouslyprescribed medication for the patient.

Another general aspect includes a system comprising: a scanningconfiguration module configured to scan a code for a cavity of amulti-dose package, the code corresponding to an electronically encodedpackage identifier configured to identify at least one previouslyprescribed medication for a patient for administration during amedication administration event, and the cavity including the at leastone previously prescribed medication as determined at a time ofpackaging the at least one previously prescribed medication for thepatient in the cavity; a prescription data access module configured toreceive a list in response to the electronically encoded packageidentifier for at least one currently prescribed medication for thepatient for administration during the medication administration event;an order interface module configured to display at least one visualindicator respectively corresponding to the at least one currentlyprescribed medication for the patient for administration during themedication administration event; an auto-confirmation module configuredto automatically confirm a presence or an exclusion of each of the atleast one currently prescribed medication in the cavity; and averification queue module configured to respectively indicate each ofthe at least one visual indicator in response to the confirming thepresence or the exclusion of each of the at least one currentlyprescribed medication in the cavity.

Implementations may include one or more of the following features. Asystem where the verification queue configured to indicate each of theat least one visual indicator in response to the confirming of theexclusion of at least one currently prescribed medication in the cavity,is further configured to differently indicate as a recently prescribedmedication not previously available for packaging in the cavity for eachof the at least one visual indicator in response to the exclusion in thecavity of the at least one of the currently prescribed medication.

The verification queue module is further configured to differentlyindicate as a medication excluded from packaging in the cavity for eachof the at least one visual indicator corresponding to at least one ofthe currently prescribed medication in response to the confirming theexclusion of the at least one currently prescribed medication in thecavity. The auto-confirmation module is further configured to:automatically confirm the presence of the at least one previouslyprescribed medication in the cavity that is discontinued in the list ofthe at least one currently prescribed medication; and differentlyindicate as a medication discontinued as being prescribed for each ofthe at least one visual indicator respectively corresponding to the atleast one previously prescribed medication in the cavity that isdiscontinued from the list of the at least one currently prescribedmedication to not be for administration during the medicationadministration event.

The verification queue module is further configured to: identify the atleast one previously prescribed medication in the cavity that isdiscontinued from the list of the at least one currently prescribedmedication using respective images of the at least one previouslyprescribed medication for the patient in the multi-dose package; andreceive a confirmation that the at least one previously prescribedmedication in the cavity that is discontinued from the list of the atleast one currently prescribed medication was identified to not be foradministration during the medication administration event.

The prescription data access module is further configured to, inresponse to receiving the list, access prescription data designated bythe electronically encoded package identifier to obtain the list for theat least one currently prescribed medication for the patient foradministration during the medication administration event. The systemfurther comprising a pharmacy dispensing system configured to: fill thecavity of the multi-dose package with the at least one previouslyprescribed medication; and print the code on the cavity to identify theat least one previously prescribed medication for the patient.

Another general aspect includes a system comprising: means for scanning,by a computing device, a code for a cavity of a multi-dose package, thecode corresponding to an electronically encoded package identifierconfigured to identify at least one previously prescribed medication fora patient for administration during a medication administration event,and the cavity including the at least one previously prescribedmedication as determined at a time of packaging the at least onepreviously prescribed medication for the patient in the cavity; meansfor receiving, by the computing device, a list in response to theelectronically encoded package identifier for at least one currentlyprescribed medication for the patient for administration during themedication administration event; means for displaying, by the computingdevice, at least one visual indicator respectively corresponding to theat least one currently prescribed medication for the patient foradministration during the medication administration event; means forautomatically confirming, by the computing device, a presence or anexclusion of each of the at least one currently prescribed medication inthe cavity; and means for respectively indicating, by the computingdevice, each of the at least one visual indicator in response to theconfirming the presence or the exclusion of each of the at least onecurrently prescribed medication in the cavity.

Implementations may include one or more of the following features. Asystem where the means for indicating each of the at least one visualindicator in response to the confirming the exclusion of the at leastone currently prescribed medication in the cavity, further comprises:means for differently indicating as a recently prescribed medication notpreviously available for packaging in the cavity for each of the atleast one visual indicator in response to the exclusion in the cavity ofthe at least one of the currently prescribed medication.

The system further comprises means for differently indicating as amedication excluded from packaging in the cavity for each of the atleast one visual indicator corresponding to at least one of thecurrently prescribed medication in response to the confirming theexclusion of the at least one currently prescribed medication in thecavity. The system further comprises means for automatically confirming,by the computing device, the presence of the at least one previouslyprescribed medication in the cavity that is discontinued in the list ofthe at least one currently prescribed medication; and means fordifferently indicating as a medication discontinued as being prescribedfor each of the at least one visual indicator respectively correspondingto the at least one previously prescribed medication in the cavity thatis discontinued from the list of the at least one currently prescribedmedication to not be for administration during the medicationadministration event.

The system further comprises means for identifying the at least onepreviously prescribed medication in the cavity that is discontinued fromthe list of the at least one currently prescribed medication usingrespective images of the at least one previously prescribed medicationfor the patient in the multi-dose package; and means for receiving, bythe computing device, a confirmation that the at least one previouslyprescribed medication in the cavity that is discontinued from the listof the at least one currently prescribed medication was identified tonot be for administration during the medication administration event.The system where the means for receiving a list in response to theelectronically encoded package identifier, further comprises: means foraccessing prescription data designated by the electronically encodedpackage identifier to obtain the list for the at least one currentlyprescribed medication for the patient for administration during themedication administration event.

It should be understood that the language used in the present disclosurehas been principally selected for readability and instructionalpurposes, and not to limit the scope of the subject matter disclosedherein.

BRIEF DESCRIPTION OF THE DRAWINGS

The present disclosure is illustrated by way of example, and not by wayof limitation in the figures of the accompanying drawings in which likereference numerals are used to refer to similar elements.

FIG. 1 is a block diagram of an example system for medicationadministration using a multi-dose packaging system.

FIGS. 2A and 2B are flowcharts of example methods for medicationadministration using a multi-dose packaging system.

FIG. 3 illustrates example scannable images for identifying medicationsin a multi-dose packaging system.

FIG. 4 illustrates example scenario indications of a presence or anexclusion of each of the currently prescribed medications with respectto a previously prescribed medications packaged in a multi-dosepackaging system.

FIG. 5 illustrates an example medication identification insert in amulti-dose packaging system.

FIG. 6 is a block diagram of an example computing system.

DETAILED DESCRIPTION

Multi-dose packaging is when a pharmacy presorts a resident'smedications by the day of the week and time of day a medication will beadministered. Multi-dose packaging may presort a patient's medicationsby the prescribed time of day for some or all of a resident's regimen oftablets and capsules for a period of time, such as one week. Prescribedmaintenance tablets and capsules are packaged together into a multi-dosepackages (MDP) by time of administration (sometime referred to as “medpass”) by the pharmacy for these medications in a compacted package forMonday-Sunday. For example, a resident may receive a 7-day bookletprefilled with the resident's regimen of tablets and capsules. Thebooklet may contain four med pass times (morning, afternoon, evening,bedtime) for each of the seven days of the week. The start consumptiondate may be Monday. Twenty-eight prefilled plastic bubbles or blisterscorresponding to each med pass may be included in the booklet and detachfrom one another along a perforated edge. Each med pass package mayinclude a plurality of prescriptions being administered on thatparticular date and time. Each med pass package may also include anelectronically readable code, such as a barcode, quick response (QR)code, an Aztec barcode, radio frequency identifier (RFID), etc.

Safety is an important consideration in use of multi-dose packaging.According to at least one study, 70% of medication errors in AssistedLiving homes result from a medication being administered at the wrongtime. Medication administration may be governed by five core principles:right resident, right medication, right dose, right route, and the righttime.

Multi-dose packaging may be improved by easy to follow visual cues. Forexample, each med pass package may include color-coded med passindicators (e.g. yellow for morning, gray for afternoon, orange forevening, blue for bedtime, etc.) with associated med pass icons (e.g.images of the rising sun, night stars, etc. to indicate the time ofday). Another example may be including high resolution pill images onthe packaging, such as inside the booklet cover, that clearly definepill color, shape, and markings to indicate which medication is which.

Each multi-dose package (MDP) may include an electronically readablecode that is readable by an eMAR application with integrated codereading capabilities, such as an image or laser-based barcode scanner.The electronically readable code may be used to validate a resident isreceiving the appropriate medication. For example, a barcode may encodethe prescription numbers for each medication in the multidose package orprovide a unique identifier that may be used to access patient, medpass, prescription, and/or other information from an eMAR database orrelated EHR system. In some embodiments, printed on each individual,detachable cavity prefilled with medications is a square barcode thathas embedded text identifying the orders of each medication packagedwithin the cavity.

In an example use, a medication aide may register the time and residentbeing administered within the eMAR interface. Next, the medication aidemay scan the barcode on the back of the detachable cavity of the medpass package. The eMAR may then use the encoded information to retrieveand confirm the expected medications have been packaged in the blister.The medication aide's scan of the barcode may queue the medications intothe facility's eMAR interface. The scan may inform the medication aideif the resident's medication regimen extends beyond what has beenpackaged in the multi-dose package. The eMAR interface may then displayall medications associated with the med pass, including both themedications in the multi-dose package and other medications that havenot been packed within the multi-dose package (due to storage orhandling restrictions, prescription changes, etc.). Those in themulti-dose package may be automatically confirmed, while others may beverified by separate scans or manual entry (such as clicking on averification icon for the medication on the eMAR interface). Further, ifa barcode on the cavity is damaged or otherwise does not properly scan,backup barcodes may be included in the med pass package.

Scanning verification from the multi-dose package may provide tripleconfirmation for the staff. If additional medications need to beadministered a medication aide is notified. If the wrong multi-dosepackage (MDP) booklet has been pulled, a medication aide will benotified. If the morning is scanned instead of bedtime, a medicationaide will be notified. By scanning the barcode, the medication aide mayhave confidence that the medications packaged are the medications theeMAR is expecting for administration.

Scanning verification also supports changes in medications, which mayoccur due to prescription changes after the multi-dose package (MDP)prefilled booklet is received. The first fill of a new medication may besent on in a single dose package (e.g. bingo card). The multi-dosepackage barcode scan may provide a visual and/or auditory reminder tothe medication aide to ensure the resident is receiving their entireregimen, including the new and separately packaged medication. Aresident may be prescribed a new medication that has not yet beenpackaged in the multi-dose booklet. When the med tech scans the barcode,any medications that were excluded from the multi-dose will not beconfirmed, but they will be identified and queued (e.g., displayed foradministration). The medication aide may be informed by the display thatthere are additional medications outside of the multi-dose packaging tobe administered.

The scan may indicate any changes to therapy of the packagedmedications. In the instance the change of therapy is a discontinuedmed, the scan will indicate to the med tech there is a packageddiscontinued medication that needs to be removed from the multi-dosepackage (MDP). If a medication that has been packaged in the multi-dosepackage (MDP) has been discontinued, the scan may inform the med tech ofthe medication change though an indicator or alert not to administer thediscontinued medication from the multi-dose package (MDP). The med techis empowered to ensure the discontinued medication is not administeredto the patient and may be provided visual references on the packageand/or eMAR interface for identifying the medication to be removed. Themedication aide is able to identify which medication will need to beremoved prior to administration guided by high resolution pill imagesprovided on a medication identification insert that has been printed onthe packaging to support proper identification.

Compatibility with multi-dose packaging with med pass scanning mayinclude configuration of an eMAR system to receive, parse, and useinformation encoded in the packaging or accessible using the codedinformation. In some embodiments, the eMAR should handle multi-dosepackages with pills from different prescriptions where the packaging islabeled by the multi-dose packaging technology and prescriptions labeledand shipped by the pharmacy that are not part of the multi-dose set oforder and may or may not include individual dose bar codes. Duringmedication administration at the facility for each resident, facilityeMAR and EHR systems that are matching prescriptions to resident basedon the barcode scanning should be able to scan a variety of codedpackages.

The multi-dose pharmacy automation machine may create the barcode usingthe value of the prescription numbers included in the packaging file forelectronic prescription orders with certain packaging requests, such asexpress requests for multi-dose packaging or as a default for multi-day,multi-med orders (e.g. 7-day packaging requests). For example, if a medpass cavity has four orders or medications in it, the barcode may be acomma separated list 142, based on the prescription data 132, with fourprescription number entries (e.g. Barcode=“R123456, R789012, R345678,R901234”). Other coding schemes may be used and an eMAR/EHRconfiguration may support multiple code schemes, including differentschemes for multi-dose packaging versus single dose packaging.

Multi-dose package (MDP) may be assembled in booklets for simple storageand organization. Each blister to be administered may have perforatededges that can easily be detached from the booklet. An oversized bubblesize, exceeding the volume occupied by the medications themselves, givesthe space for a simple punch-out that will be easy on staff when theyare opening-up perhaps hundreds of medication packaging every day. Thismay also assist consumers, patients who self-administer, and caregiverswith physical limitations in accessing the medications. Individual medpass packages may be compact enough to transport without being so smallthey are easily dropped or lost (e.g., like individual pills or bingocard cells). Users may benefit by being able to discreetly bringpackaged medications on an outing.

Approximately one to two multi-dose booklets per resident will replaceapproximately eight individual bingo cards that a resident maypreviously have received. The compact booklet facilitates an organizedmedication storage space for the community and simplified process forlocating the correct multi-dose package booklet. Booklets may haveflexibility to be neatly stacked in a med storage room or arranged withthe spines facing forward in a med cart. Med carts may be customized toaccommodate, organize, and display the booklets needed for that med cartand time period.

For example, a resident's name and room number may be printed in boldletters on the spine and arranged facing toward the medication aide. Amedication aide may scan to locate resident name and extract the bookletfor administration. In addition, other medications on separate bingocards (as needed) may be accommodated inside the cover of the bookletfor ease of organization and administration.

Time administering medications in long-term care may be substantial.This time has a real cost for facilities and erodes staff time thatcould be spent enjoying the presence of a community's residents' oraddressing other pressing needs for the facility. Medicationadministration using multi-dose packs as described herein may reduce thetime med aides spend administering medication by more than 25%.

With reference to the figures, reference numbers may be used to refer tocomponents found in any of the figures, regardless whether thosereference numbers are shown in the figure being described. Further,where a reference number includes a letter referring to one of multiplesimilar components (e.g., component 000a, 000b, and 000n), the referencenumber may be used without the letter to refer to one or all of thesimilar components.

FIG. 1 is a block diagram of an example system 100 for medicationadministration using multi-dose packaging. System 100 may include acomputing device 110, an eMAR database 114, a pharmacy dispensing system122, a pharmaceutical database 124, and an electronic health recordssystem 130, each of which may be electronically communicatively coupledvia a network 102 for interaction with one another, although othersystem configurations are possible including other devices, systems, andnetworks. For example, each device, database, and system may include, bepart of, or be hosted on one or more computing devices.

In the example shown, computing device 110 may host an eMAR application112 and be communicatively connected to code reader 116 for reading acoded identifier, such as a bar code, from multi-dose package(s) 120using a signal 118, such as light reflected from a bar code. In someembodiments, eMAR application 112 may be in communication with eMARdatabase 114 and/or prescription data 132 and patient data 134 in EHRsystem 130 for accessing prescription and patient information forverifying medications during a med pass.

For example, computing device 110 may be a med pass computing device,such as a laptop, tablet, smartphone, or similar device used inconjunction with a med cart for distributing medication in aninstitutional setting. eMAR application 112, eMAR database 114, and/orEHR system 130 may be components of a facility management system orhealthcare information network.

In another example, computing device 110 may be a computing device usedby a consumer, patient, in-home caregiver (personal or serviceprovider), or other person administering medications outside of aninstitutional setting. eMAR application 112 may be an app or similarprogram loaded on a personal computer, tablet, smartphone, or othersmart device that accesses one or more cloud-based resources forpersonal healthcare management, including eMAR database 114.

Multi-dose package(s) 120 may be filled based on prescription andpatient information and receive the coded identifier for each med passpackage in the multi-dose packages. For example, pharmacy dispensingsystem 122 may be maintained by a pharmacy or pharmacy system thatprovides multi-dose packaged medications to institutions and/orconsumers.

The network 102 may include any number of networks and/or network types.For example, the network 102 may include, but is not limited to, one ormore local area networks (LANs), wide area networks (WANs) (e.g., theInternet), virtual private networks (VPNs), wireless wide area network(WWANs), WiMAX® networks, personal area networks (PANs) (e.g.,Bluetooth® communication networks), various combinations thereof, etc.These private and/or public networks may have any number ofconfigurations and/or topologies, and data may be transmitted via thenetworks using a variety of different communication protocols including,for example, various Internet layer, transport layer, or applicationlayer protocols. For example, data may be transmitted via the networksusing TCP/IP, UDP, TCP, HTTP, HTTPS, DASH, RTSP, RTP, RTCP, VOIP, FTP,WS, WAP, SMS, MMS, XMS, IMAP, SMTP, POP, WebDAV, or other knownprotocols.

FIG. 2A is a flowchart of an example method 200 for medicationadministration using multi-dose packaging.

At 202, a plurality of prescriptions are identified for multi-dosepackaging for at least one patient. Multiple medications are packagedaccording to the dosage schedules in their respective prescriptions andgrouped according to their target administration time or med pass in amed pass cavity. At least one cavity of the multi-dose package is filledwith at least one previously prescribed medication.

At 204, a barcode is printed on each med pass cavity that encodesinformation about the medications contained therein (e.g. prescriptionnumbers) and/or a unique identifier from which such information can beaccessed. The code is printed on the cavity to identify the at least onepreviously prescribed medication for the patient.

At 206, an eMAR system or application is configured to parse the barcodeon each med pass package when scanned. In some embodiments, configuringthe eMAR may include defining one or more administrative steps,workflows, and/or interfaces that may be navigated by a user, such as amedication aide, during medication administration. For example, the eMARmay include a series of administrative steps completed for each patientduring a med pass with regard to patient verification, medication aideverification, inventory, billing, and/or other activities integratedinto med pass operations for the facility.

For each med pass, at 210 the time of day of the med pass is selectedand at 212 the patient's profile is selected, such as using an eMARinterface. At 214, the patient's multi-dose booklet is selected, a medpass cavity for the particular med pass is identified at 216, and theidentified med pass cavity is detached for medication administration at218. At 220, the barcode on the med pass cavity is scanned to identifythe medications in the med pass cavity and trigger medicationverification workflows in the eMAR system. At 222, all medications forthe med pass are displayed on the interface of the eMAR systems. At 224,the eMAR system automatically confirms medications in the med passcavity based on the scan. At 226, the medications from the med passcavity are administered to the patient.

FIG. 2B is a flowchart of an example method 230 for an eMAR systemautomating medication administration using a multi-dose package. In someembodiments, method 230 may be used in conjunction with method 200.

At 232, an electronically encoded med pass cavity identifier is receivedfrom a scan of the med pass cavity identifier on a med pass cavity. Thecomputing device 110 scans a code for a cavity of a multi-dose package120 where the code corresponds to an electronically encoded packageidentifier configured to identify at least one previously prescribedmedication for a patient for administration during a medicationadministration event. The cavity includes the at least one previouslyprescribed medication as determined at a time of packaging of the atleast one previously prescribed medication for the patient in thecavity.

At 234, the med pass cavity identifier may be parsed to determine one ormore encoded identifiers, such as a plurality of prescription numbers.

At 236, the identifier is used to access prescription data, such as thelist of orders applicable to the specific med pass, along with themedication names, descriptions, visual identifiers, administrationnotes/instructions/warnings, and other information available through thesystem. The computing device 110 accesses prescription data designatedby the electronically encoded package identifier to obtain the list 144,based on the prescription data 132, for the at least one currentlyprescribed medication for the patient for administration during themedication administration event. The computing device 110 receives thelist in response to the electronically encoded package identifier for atleast one currently prescribed medication for the patient foradministration during the medication administration event.

At 238, patient information is displayed on the interface for visualconfirmation by the user, such as based on a prior selection of thepatient or responsive to the identifier.

At 240, a verification queue of all medications to be administered tothe patient during the med pass may be displayed, such as a series oficons, table entries, or similar indicators corresponding to each of themedications for administration and verification. The computing device112 displays at least one visual indicator respectively corresponding tothe at least one currently prescribed medication for the patient foradministration during the medication administration event.

At 242, all current medications in the med pass cavity (as representedby the med pass cavity identifier) are automatically confirmed in theverification queue and include a visual indicator to that effect, suchas a colored highlight or check mark. The computing device 112automatically confirms a presence or an exclusion of each of the atleast one currently prescribed medication in the cavity. The computingdevice 112 respectively indicates each of the at least one visualindicator in response to the confirming the presence or the exclusion ofeach of the at least one currently prescribed medication in the cavity.

At 244, any new medications not included in the med pass cavity, such asorder originating after the multi-dose package was filled, but stillscheduled for administration in the med pass may be indicated as such.In response to the confirming the exclusion of at least one currentlyprescribed medication in the cavity, the at least one visual indicatordifferently indicates the recently prescribed medication as not beingpreviously available for packaging in the cavity.

At 246, any excluded medications not included in the med pass cavity,such as medications with different storage or handling requirements, butstill scheduled for administration in the med pass may be indicated assuch. The computing device 112 differently indicates as a medicationexcluded from packaging in the cavity for each of the at least onevisual indicator corresponding to at least one of the currentlyprescribed medication in response to the confirming the exclusion of theat least one currently prescribed medication in the cavity.

At 248, any discontinued medications included in the med pass cavity,such as any discontinued after the multi-dose package was filled, and nolonger scheduled for administration in the med pass, may be indicated assuch and may include additional warnings or notifications to assure thatthe discontinued medication is not administered. The computing device112 automatically confirms the presence of the at least one previouslyprescribed medication in the cavity that is discontinued in the list ofthe at least one currently prescribed medication. The computing device112 differently indicates as a medication discontinued as beingprescribed for each of the at least one visual indicator respectivelycorresponding to the at least one previously prescribed medication inthe cavity that is discontinued from the list of the at least onecurrently prescribed medication to not be for administration during themedication administration event.

At 250, any additional confirmations needed for the new and excludedmedications and/or acknowledgements of non-administration of thediscontinued medication may be received based on additional scans orother confirmation methods, such as clicking or tapping an iconassociated with the medication on the interface. Further, furtherconfirmations and protections may include identifying at least onepreviously prescribed medication in the cavity that is discontinued fromthe list of the currently prescribed medications using respective imagesof the previously prescribed medication in the multi-dose package. Thecomputing device may then receive a confirmation that the previouslyprescribed medication in the cavity that is discontinued from the listof currently prescribed medications was identified to not beadministered during the medication administration event.

At 252, verification for med pass is complete and the user may proceedto the next patient.

FIG. 3 illustrates example scannable images for identifying medicationsin a multi-dose packaging system. FIG. 3(A) illustrates an example label310 on a packet of a multi-dose package. The label 310 may includevarious information, examples of which include a patient name 316, aday/date/time-of-day indicator 322, a day of the week 328, a time of dayindicator 334, dosage and medication indicators 340, and a barcode orcode 346. Multiple medications are packaged according to the dosageschedules in their respective prescriptions and grouped according totheir target administration time or med pass in a med pass cavity. Atleast one cavity of the multi-dose package is filled with at least onepreviously prescribed medication. The barcode or code is printed on eachmed pass cavity that encodes information about the medications containedtherein (e.g. prescription numbers) and/or a unique identifier fromwhich such information can be accessed. The code 346 is printed on thecavity to identify the at least one previously prescribed medication forthe patient. While one form of code is illustrated, the code may takethe form of an electronically readable code, such as a barcode, quickresponse (QR) code, radio frequency identifier (RFID), etc.

The multi-dose pharmacy automation machine may create the barcode usingthe value of the prescription numbers included in the packaging file forelectronic prescription orders with certain packaging requests, such asexpress requests for multi-dose packaging or as a default for multi-day,multi-med orders (e.g. 7-day packaging requests). For example, a barcodemay encode the prescription numbers for each medication in the multidosepackage or provide a unique identifier that may be used to accesspatient, med pass, prescription, and/or other information from an eMARdatabase or related EHR system. In some embodiments, printed on eachindividual, detachable cavity prefilled with medications is a squarebarcode that has embedded text identifying the orders of each medicationpackaged within the cavity.

FIG. 3(B) is a list 142 of the previously prescribed medications for apatient. The resulting scan values are coded to correspond to specificmedications. For example, if a med pass cavity has four orders ormedications in it, the barcode may be a comma separated list with fourprescription number entries (e.g. Barcode=“R10016668, R10016679,R10016674, R10016673”). Other coding schemes may be used and an eMAR/EHRconfiguration may support multiple code schemes, including differentschemes for multi-dose packaging versus single dose packaging.

FIG. 3(C) illustrates a series of individual, detachable cavities360(1-4) prefilled with medications. As illustrated, printed on eachindividual, detachable cavity prefilled with medications is a squarebarcode that has embedded text identifying the orders of each medicationpackaged within the cavity.

FIG. 4 illustrates example scenario indications of a presence or anexclusion of each of the currently prescribed medications with respectto a previously prescribed medications packaged in a multi-dosepackaging system.

In the scenario illustrated in FIG. 4(A), the indicators are set inresponse to the scan of the barcode on the cavity. In the presentscenario, each of the previously prescribed medications is includedwithin the cavity as indicated, for example, by check marks or someother indicia, such as a color indicator, textual indicator, audibleindicator, etc. Accordingly, the medication aide may completeadministration by retrieving all of the prescribed medications for thepatient from the cavity.

In the scenario illustrated in FIG. 4(B), the indicators are set inresponse to the scan of the barcode on the cavity. In the presentscenario, each of the previously prescribed medications, with theexception of one medication, is included within the cavity as indicated,for example, by check marks or some other indicia, such as a colorindicator, textual indicator, audible indicator, etc. The excludedmedication is differently indicated as a medication excluded frompackaging in the cavity, but was previously or originally prescribed andfilled by a pharmacy. The excluded medication may be differentlyindicated using, for example, the absence of a confirming checkmark.Further, a note as illustrated, may indicate that the medication ispackaged outside of the cavity of the multi-dose package. Therefore, thedifferent indication confirms the exclusion of the at least onecurrently prescribed medication in the cavity. Accordingly, themedication aide may complete administration by retrieving all of theprescribed medications from the cavity and from a source outside of thecavity of the multi-dose package. Medications not suitable for packagingmay include liquids, or fragile (e.g., orally disintegrable) tablets,etc.

In the scenario illustrated in FIG. 4(C), the indicators are set inresponse to the scan of the barcode on the cavity. In the presentscenario, each of the previously prescribed medications, with theexception of one medication, is included within the cavity as indicated,for example, by check marks or some other indicia, such as a colorindicator, textual indicator, audible indicator, etc. The excludedmedication is differently indicated as a medication excluded frompackaging in the cavity, but was not previously or originally prescribedand filled by a pharmacy at the time of the packaging of the multi-dosepackage. The excluded medication may be differently indicated using, forexample, by the absence of a confirming checkmark. Further, a note, asillustrated, may indicate that the medication is an excluded medicationfrom the multi-dose package. Therefore, the different indicationconfirms the exclusion of the at least one currently prescribedmedication in the cavity. Accordingly, the medication aide may completeadministration by retrieving all of the prescribed medications from thecavity and from a source outside of the cavity of the multi-dosepackage.

In the scenario illustrated in FIG. 4(D), the indicators are set inresponse to the scan of the barcode on the cavity. In the presentscenario, each of the previously prescribed medications, with theexception of one medication, is included within the cavity as indicated,for example, by check marks or some other indicia, such as a colorindicator, textual indicator, audible indicator, etc. The excludedmedication is differently indicated as a medication excluded frompackaging in the cavity, but is currently prescribed and filled by apharmacy. The excluded medication may be differently indicated using,for example, by the absence of a confirming checkmark. Further, a note,as illustrated, may indicate that the medication is packaged outside ofthe cavity of the multi-dose package. Therefore, the differentindication confirms, using the at least one visual indicatorcorresponding to at least one of the currently prescribed medication,that at least one currently prescribed medication is excluded from thecavity and needs to be located and administered from another source(e.g., ‘bingo card’) in response to a recently filled prescription.Accordingly, the medication aide may complete administration byretrieving all of the prescribed medications from the cavity and from asource outside of the cavity of the multi-dose package.

In the scenario illustrated in FIG. 4(E), the indicators are set inresponse to the scan of the barcode on the cavity. In the presentscenario, each of the previously prescribed medications is includedwithin the cavity as indicated, however, one of the medications isdifferently indicated as being a previously prescribed medication thatis discontinued. Discontinuation of a medication may be based on anupdated prescription from a prescribing physician indicating themedication is no longer to be administered to the patient. While thenon-discontinued medications may be indicated, for example, by checkmarks or some other indicia, such as a color indicator, textualindicator, audible indicator, etc., the discontinued medication isdifferently indicated, for example, using words or initials such as “DC”for discontinued and is not to be administered during the medicationadministration event.

Furthermore, FIG. 4(F) illustrates further information that may beprovided to the medication aide in the form of an image of thediscontinued medication to assist the medication aide in identifying thediscontinued medication from other non-discontinued medications in thecavity. Yet further, a label, such as illustrated in FIG. 4(F) may beapplied to a booklet containing the multi-dose package containing thediscontinued medication.

FIG. 5 illustrates an example medication identification insert 500 in amulti-dose packaging system. The medication identification insert 500may include images, dosages, identification markings, and scannablecodes used to assist a medication aide in the identification ofmedications that form a part of previously prescribed medications. Themedication identification insert 500 may be further used by themedication aide to further confirm medications in a cavity of themulti-dose package.

FIG. 6 is a block diagram of an example computing device 600, which mayrepresent a computing device configured to implement modules depicted inFIG. 1 , such as eMAR application 112 and eMAR database 114, dependingon the implementation.

As depicted, the computing system 600 may include a processor 608, amemory 610, a communication unit 604, an output device 614, an inputdevice 612, and a data store 620, which may be communicatively coupledby a communication bus 602. The computing system 600 depicted in FIG. 6is provided by way of example and it should be understood that it maytake other forms and include additional or fewer components withoutdeparting from the scope of the present disclosure. For instance,various components of the computing device may be coupled forcommunication using a variety of communication protocols and/ortechnologies including, for instance, communication buses, softwarecommunication mechanisms, computer networks, etc. While not shown, thecomputing system 600 may include various operating systems, sensors,additional processors, and other physical configurations. The processor608, memory 610, communication unit 604, etc., are representative of oneor more of these components.

The processor 608 may execute software instructions by performingvarious input, logical, and/or mathematical operations. The processor608 may have various computing architectures to method data signals(e.g., CISC, RISC, etc.). The processor 608 may be physical and/orvirtual, and may include a single core or plurality of processing unitsand/or cores. In some implementations, the processor 608 may be coupledto the memory 610 via the bus 602 to access data and instructionstherefrom and store data therein. The bus 602 may couple the processor608 to the other components of the computing system 600 including, forexample, the memory 610, the communication unit 604, the input device612, the output device 614, and the data store 620.

The memory 610 may store and provide data access to the other componentsof the computing system 600. The memory 610 may be included in a singlecomputing device or a plurality of computing devices. In someimplementations, the memory 610 may store instructions and/or data thatmay be executed by the processor 608. For example, the memory 610 maystore eMAR application 112. The memory 610 is also capable of storingother instructions and data, including, for example, an operatingsystem, hardware drivers, other software applications, databases, etc.The memory 610 may be coupled to the bus 602 for communication with theprocessor 608 and the other components of computing system 600.

In the example shown, eMAR application 112 includes a plurality ofmodules related to operation of eMAR application 112 in accordance withthe systems and methods described above. These modules are shown byexample and may not include all modules in eMAR application 112. eMARapplication 112 may include scanning configuration 630 for receiving andparsing encoded information from a scan, prescription data access 632for accessing prescription and/or patient information based on theinformation from the scan, order interface 634 for displaying orderinformation and verification indicators to a user, verification queue636 for organizing and displaying information related to each medicationin a med pass, verification workflow 638 for defining the options andactions for navigating the verification process during a med pass, andauto-confirmation 640 for automatically confirming specific medicationsbased on the encoded information and/or information accessed.

The scanning configuration module 630 may be configured to scan a codefor a cavity of a multi-dose package, with the code corresponding to anelectronically encoded package identifier configured to identify atleast one previously prescribed medication for a patient foradministration during a medication administration event, and the cavityincluding the at least one previously prescribed medication asdetermined at a time of packaging the at least one previously prescribedmedication for the patient in the cavity.

The prescription data access module 632 may be configured to receive alist in response to the electronically encoded package identifier for atleast one currently prescribed medication for the patient foradministration during the medication administration event. Theprescription data access module 632 may be further configured to, inresponse to receiving the list, access prescription data designated bythe electronically encoded package identifier to obtain the list for theat least one currently prescribed medication for the patient foradministration during the medication administration event.

The order interface module 634 may be configured to display at least onevisual indicator respectively corresponding to the at least onecurrently prescribed medication for the patient for administrationduring the medication administration event.

The auto-confirmation module 640 may be configured to automaticallyconfirm a presence or an exclusion of each of the at least one currentlyprescribed medication in the cavity. The auto-confirmation module 640may be further configured to automatically confirm the presence of theat least one previously prescribed medication in the cavity that isdiscontinued in the list of the at least one currently prescribedmedication. The auto-confirmation module 640 may be yet furtherconfigured to differently indicate as a medication discontinued as beingprescribed for each of the at least one visual indicator respectivelycorresponding to the at least one previously prescribed medication inthe cavity that is discontinued from the list of the at least onecurrently prescribed medication to not be for administration during themedication administration event.

The verification queue module 636 may be configured to respectivelyindicate each of the at least one visual indicator in response toconfirming the presence or the exclusion of each of the at least onecurrently prescribed medication in the cavity. The verification queue636 may be configured to indicate each of the at least one visualindicator in response to the confirming of the exclusion of at least onecurrently prescribed medication in the cavity, is further configured todifferently indicate as a recently prescribed medication not previouslyavailable for packaging in the cavity for each of the at least onevisual indicator in response to the exclusion in the cavity of the atleast one of the currently prescribed medication. The verification queuemodule 636 may be further configured to differently indicate as amedication excluded from packaging in the cavity for each of the atleast one visual indicator corresponding to at least one of thecurrently prescribed medication in response to the confirming theexclusion of the at least one currently prescribed medication in thecavity. The verification queue module 636 may be further configured toidentify the at least one previously prescribed medication in the cavitythat is discontinued from the list of the at least one currentlyprescribed medication using respective images of the at least onepreviously prescribed medication for the patient in the multi-dosepackage. The verification queue module 636 may be further configured toreceive a confirmation that the at least one previously prescribedmedication in the cavity that is discontinued from the list of the atleast one currently prescribed medication was identified to not be foradministration during the medication administration event.

The memory 610 may include a non-transitory computer-usable (e.g.,readable, writeable, etc.) medium, which can be any non-transitoryapparatus or device that can contain, store, communicate, propagate ortransport instructions, data, computer programs, software, code,routines, etc., for processing by or in connection with the processor608. In some implementations, the memory 610 may include one or more ofvolatile memory and non-volatile memory (e.g., RAM, ROM, hard disk,optical disk, etc.). It should be understood that the memory 610 may bea single device or may include multiple types of devices andconfigurations.

The bus 602 can include a communication bus for transferring databetween components of a computing device or between computing devices, anetwork bus system including the network 102 or portions thereof, aprocessor mesh, a combination thereof, etc. In some implementations,eMAR application 112 and various other components operating on thecomputing device 600 (operating systems, device drivers, etc.) maycooperate and communicate via a communication mechanism included in orimplemented in association with the bus 602. The software communicationmechanism can include and/or facilitate, for example, inter-methodcommunication, local function or procedure calls, remote procedurecalls, an object broker (e.g., CORBA), direct socket communication(e.g., TCP/IP sockets) among software modules, UDP broadcasts andreceipts, HTTP connections, etc. Further, any or all of thecommunication could be secure (e.g., SSH, HTTPS, etc.).

The communication unit 604 may include one or more interface devices(I/F) for wired and wireless connectivity among the components of thesystem 100. For instance, the communication unit 604 may include, but isnot limited to, various types of known connectivity and interfaceoptions. The communication unit 604 may be coupled to the othercomponents of the computing system 600 via the bus 602. Thecommunication unit 604 can provide other connections to the network 102and to other entities of the system 100 using various standardcommunication protocols.

The input device 612 may include any device for inputting informationinto the computing system 600. In some implementations, the input device612 may include one or more peripheral devices. For example, the inputdevice 612 may include a keyboard, a pointing device, microphone, animage/video capture device (e.g., camera), RFID scanner, barcode scanner(image or laser), a touch-screen display integrated with the outputdevice 614, etc. The output device 614 may be any device capable ofoutputting information from the computing system 600. The output device614 may include one or more of a display (LCD, OLED, etc.), a printer, ahaptic device, audio reproduction device, touch-screen display, a remotecomputing device, etc. In some implementations, the output device is adisplay which may display electronic images and data output by aprocessor of the computing system 600 for presentation to a user, suchas the processor 608 or another dedicated processor.

The data store 620 may include information sources for storing andproviding access to data. In some implementations, the data store 620may store data associated with a database management system (DBMS)operable on the computing system 600. For example, the DBMS couldinclude a structured query language (SQL) DBMS, a NoSQL DMBS, variouscombinations thereof, etc. In some instances, the DBMS may store data inmulti-dimensional tables comprised of rows and columns, and manipulate,e.g., insert, query, update and/or delete, rows of data usingprogrammatic operations.

The data stored by the data store 620 may be organized and queried usingvarious criteria including any type of data stored by them, such as auser identifier, a prescription identifier, user attributes, patientattributes, facility attributes, medical administration records,time/location data, etc. The data store 620 may include data tables,databases, or other organized collections of data. In the example shown,some or all of eMAR database 114 may be stored in data store 620 and mayinclude patient information, prescription information, package or doseidentifiers, medical administration records, and other information foruse by eMAR application 112.

The data store 620 may be included in the computing system 600 or inanother computing system and/or storage system distinct from but coupledto or accessible by the computing system 600. The data stores 620 caninclude one or more non-transitory computer-readable mediums for storingthe data. In some implementations, the data stores 620 may beincorporated with the memory 610 or may be distinct therefrom.

The components 604, 608, 610, 612, and/or 614 may be communicativelycoupled by the bus 602 and/or the processor 608 to one another and/orthe other components of the computing system 600. In someimplementations, the components 604, 608, 610, 612, and/or 614 mayinclude computer logic (e.g., software logic, hardware logic, etc.)executable by the processor 608 to provide their acts and/orfunctionality. In any of the foregoing implementations, these components604, 608, 610, 612, and/or 614 may be adapted for cooperation andcommunication with the processor 608 and the other components of thecomputing system 600.

In the above description, for purposes of explanation, numerous specificdetails are set forth in order to provide a thorough understanding ofthe present disclosure. However, it should be understood that thetechnology described herein can be practiced without these specificdetails. Further, various systems, devices, and structures are shown inblock diagram form in order to avoid obscuring the description. Forinstance, various implementations are described as having particularhardware, software, and user interfaces. However, the present disclosureapplies to any type of computing device that can receive data andcommands, and to any peripheral devices providing services.

In some instances, various implementations may be presented herein interms of algorithms and symbolic representations of operations on databits within a computer memory. An algorithm is here, and generally,conceived to be a self-consistent set of operations leading to a desiredresult. The operations are those requiring physical manipulations ofphysical quantities. Usually, though not necessarily, these quantitiestake the form of electrical or magnetic signals capable of being stored,transferred, combined, compared, and otherwise manipulated. It hasproven convenient at times, principally for reasons of common usage, torefer to these signals as bits, values, elements, symbols, characters,terms, numbers, or the like.

To ease description, some elements of the system and/or the methods arereferred to using the labels first, second, third, etc. These labels areintended to help to distinguish the elements but do not necessarilyimply any particular order or ranking unless indicated otherwise.

It should be borne in mind, however, that all of these and similar termsare to be associated with the appropriate physical quantities and aremerely convenient labels applied to these quantities. Unlessspecifically stated otherwise as apparent from the following discussion,it is appreciated that throughout this disclosure, discussions utilizingterms including “processing,” “computing,” “calculating,” “determining,”“displaying,” or the like, refer to the action and processes of acomputer system, or similar electronic computing device, thatmanipulates and transforms data represented as physical (electronic)quantities within the computer system's registers and memories intoother data similarly represented as physical quantities within thecomputer system memories or registers or other such information storage,transmission or display devices.

Various implementations described herein may relate to an apparatus forperforming the operations herein. This apparatus may be speciallyconstructed for the required purposes, or it may comprise ageneral-purpose computer selectively activated or reconfigured by acomputer program stored in the computer. Such a computer program may bestored in a computer readable storage medium, including, but is notlimited to, any type of disk including floppy disks, optical disks,CD-ROMs, and magnetic disks, read-only memories (ROMs), random accessmemories (RAMs), EPROMs, EEPROMs, magnetic or optical cards, flashmemories including USB keys with non-volatile memory or any type ofmedia suitable for storing electronic instructions, each coupled to acomputer system bus.

The technology described herein can take the form of an entirelyhardware implementation, an entirely software implementation, orimplementations containing both hardware and software elements. Forinstance, the technology may be implemented in software, which includesbut is not limited to firmware, resident software, microcode, etc.Furthermore, the technology can take the form of a computer programobject accessible from a computer-usable or computer-readable mediumproviding program code for use by or in connection with a computer orany instruction execution system. For the purposes of this description,a computer-usable or computer readable medium can be any non-transitorystorage apparatus that can contain, store, communicate, propagate, ortransport the program for use by or in connection with the instructionexecution system, apparatus, or device.

A data processing system suitable for storing and/or executing programcode may include at least one processor coupled directly or indirectlyto memory elements through a system bus. The memory elements can includelocal memory employed during actual execution of the program code, bulkstorage, and cache memories that provide temporary storage of at leastsome program code in order to reduce the number of times code must beretrieved from bulk storage during execution. Input or I/O devices(including but not limited to keyboards, displays, pointing devices,etc.) can be coupled to the system either directly or throughintervening I/O controllers.

Network adapters may also be coupled to the system to enable the dataprocessing system to become coupled to other data processing systems,storage devices, remote printers, etc., through intervening privateand/or public networks. Wireless (e.g., Wi-Fi™) transceivers, Ethernetadapters, and Modems, are just a few examples of network adapters. Theprivate and public networks may have any number of configurations and/ortopologies. Data may be transmitted between these devices via thenetworks using a variety of different communication protocols including,for example, various Internet layer, transport layer, or applicationlayer protocols. For example, data may be transmitted via the networksusing transmission control protocol/Internet protocol (TCP/IP), userdatagram protocol (UDP), transmission control protocol (TCP), hypertexttransfer protocol (HTTP), secure hypertext transfer protocol (HTTPS),dynamic adaptive streaming over HTTP (DASH), real-time streamingprotocol (RTSP), real-time transport protocol (RTP) and the real-timetransport control protocol (RTCP), voice over Internet protocol (VOIP),file transfer protocol (FTP), WebSocket (WS), wireless access protocol(WAP), various messaging protocols (SMS, MMS, XMS, IMAP, SMTP, POP,WebDAV, etc.), or other known protocols.

Finally, the structure, algorithms, and/or interfaces presented hereinare not inherently related to any particular computer or otherapparatus. Various general-purpose systems may be used with programs inaccordance with the teachings herein, or it may prove convenient toconstruct more specialized apparatus to perform the required methodblocks. The required structure for a variety of these systems willappear from the description above. In addition, the specification is notdescribed with reference to any particular programming language. It willbe appreciated that a variety of programming languages may be used toimplement the teachings of the specification as described herein.

The foregoing description has been presented for the purposes ofillustration and description. It is not intended to be exhaustive or tolimit the specification to the precise form disclosed. Manymodifications and variations are possible in light of the aboveteaching. As will be understood by those familiar with the art, thespecification may be embodied in other specific forms without departingfrom the spirit or essential characteristics thereof. Likewise, theparticular naming and division of the modules, routines, features,attributes, methodologies and other aspects are not mandatory orsignificant, and the mechanisms that implement the specification or itsfeatures may have different names, divisions and/or formats.Furthermore, the modules, routines, features, attributes, methodologiesand other aspects of the disclosure can be implemented as software,hardware, firmware, or any combination of the foregoing. Also, wherevera component, an example of which is a module, of the specification isimplemented as software, the component can be implemented as astandalone program, as part of a larger program, as a plurality ofseparate programs, as a statically or dynamically linked library, as akernel loadable module, as a device driver, and/or in every and anyother way known now or in the future. Additionally, the disclosure is inno way limited to implementation in any specific programming language,or for any specific operating system or environment.

What is claimed is:
 1. A computer-implemented method, comprising:scanning an electronically encoded package identifier, theelectronically encoded package identifier corresponding to a cavity of amulti-dose package and encoding medication administered to a patientduring a medication administration event as determined at a time ofpackaging, the medication administered to the patient during themedication administration event including a first medication and anexcluded medication, the excluded medication prescribed at the time ofpackaging the first medication in the cavity but excluded from thecavity; displaying, by a computing device, visual indicatorsrespectively corresponding to each currently prescribed medication foradministration during the medication administration event, the currentlyprescribed medication for administration during the medicationadministration event including the first medication and the excludedmedication; and respectively indicating, by the computing device in thedisplay, a presence in or the exclusion from the cavity of eachcurrently prescribed medication for administration during the medicationadministration event.
 2. The computer-implemented method of claim 1,wherein indicating the exclusion of a currently prescribed, secondmedication from the cavity, further comprises: differently indicating,as a recently prescribed medication not previously available forpackaging in the cavity, a visual indicator associated with a secondmedication, the second medication not prescribed at the time ofpackaging the first medication in the cavity.
 3. Thecomputer-implemented method of claim 1, further comprising: differentlyindicating the excluded medication, as a medication excluded frompackaging in the cavity, in response to confirming the exclusion of theexcluded medication.
 4. The computer-implemented method of claim 1,further comprising: automatically confirming, by the computing device,the presence of a previously prescribed medication in the cavity that isdiscontinued in a list of currently prescribed medication; anddifferently indicating, as a medication discontinued and not foradministration during the medication administration event, thepreviously prescribed medication in the cavity that is discontinued fromthe list of currently prescribed medication.
 5. The computer-implementedmethod of claim 4, further comprising: identifying the previouslyprescribed medication in the cavity that is discontinued from a list ofthe currently prescribed medication using an image of the previouslyprescribed medication that is discontinued but packaged in the cavity ofthe multi-dose package; and receiving, by the computing device, aconfirmation that the previously prescribed medication in the cavitythat is discontinued from the list of currently prescribed medicationwas identified to not be for administration during the medicationadministration event.
 6. The computer-implemented method of claim 1,wherein the electronically encoded package identifier includes aconcatenation of a first prescription identifier representing the firstmedication and a second prescription identifier representing a secondmedication, wherein the second medication is the excluded medication. 7.The computer-implemented method of claim 1, further comprising: fillingthe cavity of the multi-dose package; and printing the electronicallyencoded package identifier on the cavity.
 8. A system, comprising: oneor more processors; and a memory storing instructions that, whenexecuted by the one or more processors, cause the system to: scan anelectronically encoded package identifier, the electronically encodedpackage identifier corresponding to a cavity of a multi-dose package andencoding medication administered to a patient during a medicationadministration event as determined at a time of packaging, themedication administered to the patient during the medicationadministration event including a first medication and an excludedmedication, the excluded medication prescribed at the time of packagingthe first medication in the cavity but excluded from the cavity; displayat least one visual indicator respectively corresponding to eachcurrently prescribed medication for the patient for administrationduring the medication administration event, the currently prescribedmedication for administration during the medication administration eventincluding the first medication and the excluded medication; andrespectively indicate a presence in or the exclusion from the cavity ofeach currently prescribed medication in a display.
 9. The system ofclaim 8, wherein indicating the exclusion of a currently prescribed,second medication from the cavity, instructions, when executed by theone or more processors, further cause the system to: differentlyindicate, as a recently prescribed medication not previously availablefor packaging in the cavity, a visual indicator associated with a secondmedication, the second medication not prescribed at the time ofpackaging the first medication in the cavity.
 10. The system of claim 8,wherein the instructions, when executed by the one or more processors,further cause the system to: differently indicate the excludedmedication, as a medication excluded from packaging in the cavity, inresponse to confirming the exclusion of the excluded medication.
 11. Thesystem of claim 8, wherein instructions, when executed by the one ormore processors, further cause the system to: automatically confirm thepresence of a previously prescribed medication in the cavity that isdiscontinued in a list of currently prescribed medication; anddifferently indicate, as a medication discontinued and not foradministration during the medication administration event, thepreviously prescribed medication in the cavity that is discontinued fromthe list of currently prescribed medication.
 12. The system of claim 11,wherein the instructions, when executed by the one or more processors,further cause the system to: identify the previously prescribedmedication in the cavity that is discontinued from a list of currentlyprescribed medication using an image of the previously prescribedmedication that is discontinued but packaged in the cavity of themulti-dose package; and receive a confirmation that the previouslyprescribed medication in the cavity that is discontinued from the listof currently prescribed medication was identified to not be foradministration during the medication administration event.
 13. Thesystem of claim 8, wherein the electronically encoded package identifierincludes a concatenation of a first prescription identifier representingthe first medication and a second prescription identifier representing asecond medication, wherein the second medication is the excludedmedication.
 14. The system of claim 8, wherein the instructions, whenexecuted by the one or more processors, further cause the system to:fill the cavity of the multi-dose package; and print the electronicallyencoded package identifier on the cavity.
 15. A system, comprising:means for scanning an electronically encoded package identifier, theelectronically encoded package identifier corresponding to a cavity of amulti-dose package and encoding medication administered to a patientduring a medication administration event as determined at a time ofpackaging, the medication administered to the patient during themedication administration event including a first medication and anexcluded medication, the excluded medication prescribed at the time ofpackaging the first medication in the cavity but excluded from thecavity; means for displaying at least one visual indicator respectivelycorresponding to each currently prescribed medication for the patientfor administration during the medication administration event, thecurrently prescribed medication for administration during the medicationadministration event including the first medication and the excludedmedication; and means for indicating a presence in or the exclusion fromthe cavity of each currently prescribed medication.
 16. The system ofclaim 15, wherein the means for indicating the presence in or theexclusion of currently prescribed medication from the cavity, furthercomprises: means for differently indicating, as a recently prescribedmedication not previously available for packaging in the cavity, avisual indicator associated with a second medication, the secondmedication not prescribed at the time of packaging the first medicationin the cavity.
 17. The system of claim 15, further comprising: means fordifferently indicating the excluded medication, as a medication excludedfrom packaging in the cavity, in response to confirming the exclusion ofthe excluded medication.
 18. The system of claim 15, further comprising:means for automatically confirming the presence of a previouslyprescribed medication in the cavity that is discontinued in a list ofcurrently prescribed medication; and means for differently indicating asa medication discontinued and not for administration during themedication administration event, the previously prescribed medication inthe cavity that is discontinued from the list of currently prescribedmedication.
 19. The system of claim 18, further comprising: means foridentifying the previously prescribed medication in the cavity that isdiscontinued from a list of currently prescribed medication using animage of the previously prescribed medication that is discontinued butpackaged in the cavity of the multi-dose package; and means forreceiving a confirmation that the previously prescribed medication inthe cavity that is discontinued from the list of currently prescribedmedication was identified to not be for administration during themedication administration event.
 20. The system of claim 15, wherein theelectronically encoded package identifier includes a concatenation of afirst identifier associated with the first medication and a secondidentifier associated with the second medication, wherein the secondmedication is the excluded medication.